Citation Nr: 18157272 Decision Date: 12/13/18 Archive Date: 12/12/18 DOCKET NO. 16-19 330A DATE: December 13, 2018 ORDER Entitlement to service connection for a left shoulder strain is DENIED. Entitlement to service connection for a right shoulder strain is DENIED. Entitlement to service connection for degenerative joint disease (DJD) of the cervical spine is DENIED. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is DENIED. FINDINGS OF FACT 1. The weight of the evidence is against a finding that the Veteran’s currently diagnosed left shoulder strain either began during, or was otherwise caused by, her military service. 2. The weight of the evidence is against a finding that the Veteran’s currently diagnosed right shoulder strain either began during, or was otherwise caused by, her military service. 3. The weight of the evidence is against a finding that the Veteran’s currently diagnosed degenerative joint disease of the cervical spine either began during, or was otherwise caused by, her military service. 4. The weight of the evidence does not establish that the Veteran has a current acquired psychiatric disorder, to include posttraumatic stress disorder. CONCLUSIONS OF LAW 1. The criteria for entitlement to service connection for a left shoulder strain have not been satisfied. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). 2. The criteria for entitlement to service connection for a right shoulder strain have not been satisfied. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). 3. The criteria for entitlement to service connection for a degenerative joint disease of the cervical spine have not been satisfied. 38 U.S.C. §§ 1110, 5103, 5103A, 5107 (2012); 38 C.F.R. §§ 3.102, 3.159, 3.303 (2017). 4. The criteria for entitlement to service connection for an acquired psychiatric disability, to include posttraumatic stress disorder, have not been satisfied. 38 U.S.C. §§ 1101, 1131, 1133, 5103, 5103A, 5107 (West 2014); 38 C.F.R. §§ 3.102, 3.159, 3.303, 3.304, 4.125 (2017). REASONS AND BASES FOR FINDINGS AND CONCLUSIONS The Veteran served honorably in the United States Navy from July 1976 to May 1986. Service Connection Generally, direct service connection will be granted if the evidence demonstrates that a current disability resulted from a disease incurred in or aggravated by active military service. 38 U.S.C. §1110; 38 C.F.R. §3.303 (a). To grant the Veteran’s appeal, the Board must identify three requisite claim elements: (1) a current disability; (2) in-service incurrence or aggravation of a disease or injury; and (3) a causal relationship, i.e., a nexus, between the claimed in-service disease or injury and the current disability. Holton v. Shinseki, 557 F.3d 1362, 1366 (Fed. Cir. 2009); 38 C.F.R. §3.303 (a). The VA is responsible for determining whether the evidence supports the claim or is in relative equipoise (with the Veteran prevailing in either event) or whether a preponderance of the evidence is against the claim (in which case the claim is denied). Gilbert v. Derwinski, 1 Vet. App. 49 (1990); 38 U.S.C. §5107 (b). 1. Entitlement to service connection for a left shoulder strain is denied. In February 2013, the Veteran submitted her VA Form 21-526. Therein, the Veteran initiated her entitlement claim for service connection for a left shoulder injury, due to an assault. Again, a service connection claim may be granted for a disability resulting from a disease or injury incurred in, or aggravated by, active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To substantiate service-connection entitlement, a Veteran must show a present disability, in-service incurrence or aggravation of a disease or injury, and nexus between the first and second requisite elements. Holton, 557 F.3d at 1366. In each case where service connection for any disability is sought, due consideration shall be given to the places, types, and circumstances of such Veteran’s service as shown by such Veteran’s service record, the official history of each organization in which such Veteran served, such Veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154 (a). In March 2013, the Veteran’s treatment notations from the Hampton VA Medical Center were associated with the claims file. Therein, on December 9, 2006, Dr. NK diagnosed the Veteran with a left shoulder pain. At that time, Dr. NK observed that the pain had been ongoing for two weeks, following the Veteran’s fall in the shower. In March 2013, the Veteran underwent a VA examination to address the nature and etiology of any currently left shoulder strain. At that time, the VA provider noted a diagnosis for bilateral shoulder strain. Within the history portion of the report, the VA provider observed that, “(Veteran) was hit by her spouse at the base of her skull and neck during a domestic dispute, reporting painful shoulders, pain that radiates to bilateral shoulders, sore biceps, and achy sensation during cold weather. Complaints of shoulder pain to the HVAMC began in 2006 when shell fell in the shower. Her shoulder films in 12/2006 demonstrated no fracture and no DJD.” Within the remarks section, the VA provider observed no evidence of fracture, normal alignment, no degenerative changes, and no soft tissue abnormality. Ultimately, the VA provider opined that, “(t)he claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event or illness.” In the supporting rationale, the VA provider relayed that, “(t)here is a report of a specific injury to the cervical neck from her spouse in 1984. She had a neck sprain that resolved completely at the time of her separation from service as noted on her discharge exam no documented shoulder or neck injury or pain April 9, 1986.” Ultimately, the VA provider observed that, “(i)n this case, the domestic situation occurred in 1984 with no further care or complaints of neck and shoulder pain while receiving care at the HVAMC 2002.” In March 2014, the Veteran submitted her notice of disagreement (NOD). Therein, the Veteran posited that, “I should be service connected for my bilateral shoulder strain since I did receive treatment and medication for my condition while on active duty. Since I separated from active duty, I continuously am prescribed ibuprofen for my bilateral shoulder strain, which I take multiple times each week as needed for pain that I experience.” In September 2014, the Veteran’s service treatment records (STRs) were associated with her claims file. Therein, in August 1984, the following note was entered at the Naval Station Branch Clinic: “marital discord ~ 1 yr. Last month has been considering divorce. Husband physically abuses her on rare occasions, as today. Pt. states she was hit in the back of her head with an opened hand. This is the first time he has been very physical(). About 3 yrs ago he ‘choked’ her while in an argument.” In September 1984, the Veteran was observed to demonstrate tenderness above the left scapula to point pressure. In January 2017, the Veteran’s primary care physician submitted a statement. Therein, Dr. ALS commences by noting that, “(the Veteran) relates that the following problems as starting during her military service: neck and low back pain, shoulder pain, knee pain, depression and anxiety, and hearing loss and tinnitus which has not been evaluated here.” Dr. ALS revealed that, “(the Veteran) suffers from chronic neck pain that extends to mid-back. It is always there . . . (s)he cannot sit or stand for a prolonged time without changing position or she has an exacerbation of her neck and upper back pain.” At that time, Dr. ALS revealed that, “(t)his neck/back/headache pain started after a traumatic incident in 1984 while she was still active duty.” Also, Dr. ALS stated that, “(the Veteran) also suffers from pain both shoulders which was caused by the same trauma that injured her neck.” Initially, the Board notes that there is no indication that Dr. ALS reviewed the Veteran’s claims file and/or service treatment records. In essence, Dr. ALS offered a conclusory statement about the etiology of the Veteran’s left shoulder strain. This type of conclusory medical opinion is of little probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (explaining that “most of the probative value of a medical opinion comes from its reasoning”). Moreover, to the extent that the Veteran reported a continuity of symptoms since service to Dr. ALS, this report of a continuity of symptoms during service is not supported by the evidence. In this regard, the Board observes that the examination of the Veteran’s upper extremities and spine and other musculoskeletal systems was within normal limits at the time of her April 1986 discharge examination. Moreover, the Veteran reported at the time of her discharge examination denied any current complaints of painful or “trick” shoulder or elbow. This evidence weighs strongly against her current assertions of a continuity of symptoms since service. As Dr. ALS appears to have relied on an inaccurate medical history, the opinion is of little probative value. See Monzingo v. Shinseki, 26 Vet. App. 97, 107 (2012) (“If [an] opinion is based on an inaccurate factual premise, then it is correct to discount it entirely.” (citing Reonal v. Brown, 5 Vet. App. 458, 461 (1993)); see also Acevedo v. Shinseki, 25 Vet. App. 286, 293 (2012) (“[A]n adequate medical report must rest on correct facts and reasoned medical judgment so as [to] inform the Board on a medical question and facilitate the Board’s consideration and weighing of the report against any contrary reports.”). The Board finds that the Veteran maintains a current diagnosis for a left shoulder strain. The Board also observes that the STRs note an in-service injury to the Veteran’s left scapula, resulting from a domestic incident with her former husband. Therefore, the Board concludes that the first and second requisite elements of a claim for entitlement to service connection are present. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a); see also Holton, 557 F.3d at 1366. However, the weight of the competent and probative evidence fails to identify a nexus between the Veteran’s current left shoulder strain and the in-service domestic incident with her ex-husband. The Board accordingly places greater weight on the report from the VA provider March 2013. Unlike the opinion proffered by Dr. ALS, the VA examiner, the opinion of the VA examiner was based on review of the Veteran entire medical history and include review of pertinent medical documentation, both during and following service. The VA examiner opinion that the Veteran’s inservice shoulder injury resolved without residual disability is consistent with the Veteran’s service treatment that do not show subsequent complaints pertaining to the shoulder and a normal physical examination at service separation. Thus, it is afforded greater probative value. Absent substantiation of the third requisite service-connection element, the Veteran’s entitlement claim for a left shoulder strain must be denied. Ultimately, the Board finds that the preponderance of the evidence stands counter to the Veteran’s left shoulder strain claim. Since the preponderance of the evidence is against this left shoulder strain claim, the provisions of 38 U.S.C. § 5107(b), regarding reasonable doubt, are not applicable. The Veteran’s claim of entitlement to service connection for a left shoulder strain must be denied, because the preponderance of the evidence weighs against her claim. 2. Entitlement to service connection for a right shoulder strain is denied. In February 2013, the Veteran submitted her VA Form 21-526. Therein, the Veteran initiated her entitlement claim for service connection for a right shoulder injury, due to an assault. Again, a service connection claim may be granted for a disability resulting from a disease or injury incurred in, or aggravated by, active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To substantiate service-connection entitlement, a Veteran must show a present disability, in-service incurrence or aggravation of a disease or injury, and nexus between the first and second requisite elements. Holton, 557 F.3d at 1366. In each case where service connection for any disability is sought, due consideration shall be given to the places, types, and circumstances of such Veteran’s service as shown by such Veteran’s service record, the official history of each organization in which such Veteran served, such Veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154 (a). In March 2013, the Veteran underwent a VA examination to address the nature and etiology of any currently right shoulder strain. At that time, the VA provider noted a diagnosis for bilateral shoulder strain. Within the history portion of the report, the VA provider observed that, “(Veteran) was hit by her spouse at the base of her skull and neck during a domestic dispute, reporting painful shoulders, pain that radiates to bilateral shoulders, sore biceps, and achy sensation during cold weather.” Within the remarks section, the VA provider observed no evidence of fracture, normal alignment, no degenerative changes, and no soft tissue abnormality. Ultimately, the VA provider opined that, “(t)he claimed condition was less likely than not (less than 50 percent probability) incurred in or caused by the claimed in-service injury, event or illness.” In the supporting rationale, the VA provider relayed that, “(t)here is a report of a specific injury to the cervical neck from her spouse in 1984. She had a neck sprain that resolved completely at the time of her separation from service as noted on her discharge exam no documented shoulder or neck injury or pain April 9, 1986.” Ultimately, the VA provider observed that, “(i)n this case, the domestic situation occurred in 1984 with no further care or complaints of neck and shoulder pain while receiving care at the HVAMC 2002.” In March 2014, the Veteran submitted her notice of disagreement (NOD). Therein, the Veteran posited that, “I should be service connected for my bilateral shoulder strain since I did receive treatment and medication for my condition while on active duty. Since I separated from active duty, I continuously am prescribed ibuprofen for my bilateral should strain, which I take multiple times each week as needed for pain that I experience.” In September 2014, the Veteran’s service treatment records (STRs) were associated with her claims file. Therein, in August 1984, the following note was entered at the Naval Station Branch Clinic: “marital discord ~ 1 yr. Last month has been considering divorce. Husband physically abuses her on rare occasions, as today. Pt. states she was hit in the back of her head with an opened hand. This is the first time he has been very physical(). About 3 yrs ago he ‘choked’ her while in an argument.” In September 1984, the Veteran was observed to demonstrate cervical spasms and tenderness to palpation, spasms, and limited range of motion of the right trapezius. In January 2017, the Veteran’s primary care physician submitted a statement. Therein, Dr. ALS commences by noting that, “(the Veteran) relates that the following problems as starting during her military service: neck and low back pain, shoulder pain, knee pain, depression and anxiety, and hearing loss ant tinnitus which has not been evaluated here.” Dr. ALS revealed that, “(the Veteran) suffers from chronic neck pain that extends to mid-back. It is always there . . . (s)he cannot sit or stand for a prolonged time without changing position or she has an exacerbation of her neck and upper back pain.” At that time, Dr. ALS revealed that, “(t)his neck/back/headache pain started after a traumatic incident in 1984 while she was still active duty.” Also, Dr. ALS stated that, “(the Veteran) also suffers from pain both shoulders which was caused by the same trauma that injured her neck.” Initially, the Board notes that there is no indication that Dr. ALS reviewed the Veteran’s claims file and/or service treatment records. In essence, Dr. ALS offered a conclusory statement about the etiology of the Veteran’s right shoulder strain. This type of conclusory medical opinion is not warranted probative weight. See Nieves-Rodriguez v. Peake, 22 Vet. App. 295, 304 (explaining that “most of the probative value of a medical opinion comes from its reasoning”). Moreover, as with the left shoulder, the Veteran’s separate examination included a normal clinical examination and lack of right shoulder related complaints at service. The Board finds that the Veteran maintains a current diagnosis for a right shoulder strain. The Board also observes that the STRs note an in-service injury to the Veteran’s right scapula, which resulted from a domestic incident with her former husband. Meaning, the Board concludes that the first and second requisite elements of a claim for entitlement to service connection are present. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a); see also Holton, 557 F.3d at 1366. However, the weight of the competent and probative evidence fails to identify a nexus between the Veteran’s current right shoulder strain and the in-service domestic incident with her former husband. The Board again places greater probative weight on the opinion reached by the VA provider in March 2013. Unlike the opinion proffered by Dr. ALS, the VA examiner, the opinion of the VA examiner was based on review of the Veteran entire medical history and include review of pertinent medical documentation, both during and following service. The VA examiner opinion that the Veteran’s inservice shoulder injury resolved without residual disability is consistent with the Veteran’s service treatment that do not show subsequent complaints pertaining to the shoulder and a normal physical examination at service separation. Thus, it is afforded greater probative value. Absent substantiation of the third requisite service-connection element, the Veteran’s entitlement claim for a right shoulder strain must be denied. Ultimately, the Board finds that the preponderance of the evidence stands counter to the Veteran’s right shoulder strain claim. Since the preponderance of the evidence is against this right shoulder strain claim, the provisions of 38 U.S.C. § 5107(b), regarding reasonable doubt, are not applicable. The Veteran’s claim of entitlement to service connection for a right shoulder strain must be denied, because the preponderance of the evidence weighs against her claim. 3. Entitlement to service connection for degenerative joint disease (DJD) of the cervical spine is denied. In February 2013, the Veteran submitted her VA Form 21-526. Therein, the Veteran initiated her entitlement claim for service connection for a neck injury, due to an assault. Again, a service connection claim may be granted for a disability resulting from a disease or injury incurred in, or aggravated by, active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To substantiate service-connection entitlement, a Veteran must show a present disability, in-service incurrence or aggravation of a disease or injury, and nexus between the first and second requisite elements. Holton, 557 F.3d at 1366. In each case where service connection for any disability is sought, due consideration shall be given to the places, types, and circumstances of such Veteran’s service as shown by such Veteran’s service record, the official history of each organization in which such Veteran served, such Veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154 (a). In March 2013, the Veteran submitted her VA Form 21-0781a. Therein, the Veteran stated that, “On or about 09/01/1984 while on authorized liberty from my Command . . . (m)y now ex-husband . . . physically assaulted me by striking me, with his fist to the back of my neck (several hard blows to the neck) resulting in injury to my neck area which I reported to medical and my command as well as local law enforcement . . .. This is not the first time that my former husband . . . physically assaulted and mentally abused me.” In March 2013, the Veteran underwent a VA examination to address the nature and etiology of any currently endured cervical spine disorder. At that time, the VA provider noted a diagnosis for cervical degenerative disc disease, which was assigned in March 2013. Within the history portion, the VA provider observed that during and after military service, the Veteran had worked in a retail store. The VA provider also noted that, after Navy service, the Veteran had been employed as a certified nursing assistant and as security personnel. After review of the record, the VA provider noted that Veteran’s spouse hit her in the skull and neck during a domestic dispute in September 1984. The VA provider observed that, while the Veteran was seen at the Hampton VAMC from 2002 thru 2013, she did not complain of neck problems at those treatments / visits. Ultimately, the VA provider opined that, “(i)t is less likely than not (less than a 50/50 probability) that the Veteran’s DJD of the Cervical Spine was incurred during military service.” In the supporting rationale, the VA provider relayed that, “(t)here is a report of a specific injury to the cervical neck from her spouse in 1984. She had a neck sprain that resolved completely at the time of her separation from service as noted on her discharge exam no documented shoulder or neck injury or pain April 9, 1986.” The VA provider also relayed that, “(the Veteran’s) x-rays demonstrate C4 - C7 DDD which is likely the result of her work in retail, and as a CNA. A remote neck strain would not cause DDD.” Ultimately, the VA provider observed “(i)n this case, the domestic situation occurred in 1984 with no further care or complaints of neck and shoulder pain while receiving care at the HVAMC 2002.” In March 2014, the Veteran submitted her notice of disagreement (NOD). Therein, the Veteran posited that, “I should be service connected for my degenerative disc disease, cervical spine since the event that caused this condition occurred while on active duty. The condition still causes me pain and discomfort, which I am prescribed medication to take as needed.” The Board notes that, while the Veteran is competent to comment about the symptoms she has observed during the course of her claimed disability, she is not competent to identify the medically complex etiology for her DJD of the cervical spine. See Clemons v. Shinseki, 23 Vet. App. 1, 4-5 (2009) (citing Espiritu v. Derwinski, 2 Vet. App. 492, 494-95 (1992)). In September 2014, the Veteran’s service treatment records (STRs) were associated with her claims file. Therein, in August 1984, the following note was entered at the Naval Station Branch Clinic: “marital discord ~ 1 yr. Last month has been considering divorce. Husband physically abuses her on rare occasions, as today. Pt. states she was hit in the back of her head with an opened hand. This is the first time he has been very physical (). About 3 yrs ago he ‘choked’ her while in an argument.” On examination, the clinician noted tenderness mid-nape of neck, limited ROM in lateral flexion only, no spasm noted, and no ecchymosis. Neurologically, the Veteran was generally intact, and there were no facial contusions or bruises. In September 1984, the Veteran was observed to demonstrate cervical spasms. In January 2015, the Veteran’s primary care physician submitted a statement. Therein, Dr. ALS revealed that, “(the Veteran) suffers from chronic neck pain that extends to mid-back. It is always there . . . (t)his neck/back/headache pain started after a traumatic incident in 1984 while she was still active duty.” In January 2017, the Veteran’s primary care physician submitted another statementin support of the Veteran’s claim. Therein, Dr. ALS commences by noting that, “(the Veteran) relates that the following problems as starting during her military service: neck and low back pain, shoulder pain, knee pain, depression and anxiety, and hearing loss ant tinnitus which has not been evaluated here.” Dr. ALS revealed that, “(the Veteran) suffer from chronic neck pain that extends to mid-back. It is always there . . . (s)he cannot sit or stand for a prolonged time without changing position or she has an exacerbation of her neck and upper back pain.” At that time, Dr. ALS revealed that, “(t)his neck/back/headache pain started after a traumatic incident in 1984 while she was still active duty.” The Board cannot assign probative weight to the opinion of Dr. ALS, regarding the etiology of the Veteran’s current DJD of the cervical spine. Important to this Board analysis, Dr. ALS provided no support for her opinion in the form of reference to medical treatises, or other information to determine the rationale behind her opinion. Moreover, Dr. ALS does not discuss the lack of pertinent findings at the time of the Veteran’s service separation examination. As Dr. ALS’s opinion is unsupported by adequate rationale, the Board finds it is inadequate to be of probative value to the Veteran’s claim. See Reonal v. Brown, 5 Vet. App. 458, 461 (1993)(an opinion without any rationale against which to evaluate the probative value of the determination is inadequate). The Board finds that the Veteran maintains a current diagnosis for DJD of the cervical spine. The Board also observes that the STRs note an in-service injury to the Veteran’s cervical spine, which resulted from a domestic incident with her former husband. Meaning, the Board concludes that the first and second requisite elements of a claim for entitlement to service connection are present. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a); see also Holton, 557 F.3d at 1366. However, the weight of the competent and probative evidence fails to identify a nexus between the Veteran’s current DJD of the cervical spine and the in-service domestic incident with her former husband. Unlike the opinion proffered by Dr. ALS, the VA examiner, the opinion of the VA examiner was based on review of the Veteran entire medical history and include review of pertinent medical documentation, both during and following service. The VA examiner opinion that the Veteran’s inservice injury resolved is consistent with the Veteran’s service treatment that do not show subsequent complaints pertaining to the shoulder and a normal physical examination at service separation. Thus, it is afforded greater probative value. The Board accordingly places greater weight on the report from the VA provider in March 2013. Absent substantiation of the third requisite service-connection element, the Veteran’s entitlement claim for DJD of the cervical spine must be denied. Ultimately, the Board finds that the preponderance of the evidence stands counter to the Veteran’s entitlement claim for DJD of the cervical spine. Since the preponderance of the evidence is against this cervical spine claim, the provisions of 38 U.S.C. § 5107(b), regarding reasonable doubt, are not applicable. The Veteran’s claim of entitlement to service connection for DJD of the cervical spine must be denied, because the preponderance of the evidence weighs against her claim.  4. Entitlement to service connection for an acquired psychiatric disorder, to include posttraumatic stress disorder (PTSD), is denied. In February 2013, the Veteran submitted her VA Form 21-526. Therein, the Veteran initiated her entitlement claim for service connection for PTSD, due to a personal assault. Again, a service connection claim may be granted for a disability resulting from a disease or injury incurred in, or aggravated by, active service. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a). To substantiate service-connection entitlement, a Veteran must show a present disability, in-service incurrence or aggravation of a disease or injury, and nexus between the first and second requisite elements. Holton, 557 F.3d at 1366. In each case where service connection for any disability is sought, due consideration shall be given to the places, types, and circumstances of such Veteran’s service as shown by such Veteran’s service record, the official history of each organization in which such Veteran served, such Veteran’s medical records, and all pertinent medical and lay evidence. 38 U.S.C. § 1154 (a). In March 2013, the Veteran submitted her VA Form 21-0781a. Therein, the Veteran stated that, “On or about 09/01/1984 while on authorized liberty from my Command . . . (m)y now ex-husband . . . physically assaulted me by striking me, with his fist to the back of my neck (several hard blows to the neck) resulting in injury to my neck area which I reported to medical and my command as well as local law enforcement . . .. This is not the first time that my former husband . . . physically assaulted and mentally abused me.” In March 2013, the Veteran’s treatment notations at the Hampton VA Medical Center were associated with her claims file. Therein, in June 2007, Dr. A-EM noted depressive disorder, not otherwise specified; homelessness and unemployment. Within a September 2007 Domiciliary Note, a diagnosis of “adjustment disorder with depressed mood, relationship problems homeless” was reported. In a February 2013 Case Management Treatment Plan Note, it was reported that the Veteran demonstrated the symptoms of an adjustment disorder with depressed mood. In April 2013, the Veteran underwent a VA examination to address the nature and etiology of any currently endured PTSD. In the resultant report, Dr. HRP noted that, “(the Veteran) presented on time and appeared to be in good spirits. When asked directly, she indicated that of late, she is in a ‘good mood . . . most days.’ Personal hygiene was good, and she was casually dressed. Rapport was easily established with this individual, who was quite gregarious. She was oriented to all spheres and understood the nature of the present evaluation.” Ultimately, Dr. HRP reported that the Veteran did not satisfy the criteria for a PTSD diagnosis under the DSM-IV criteria. Within the supporting rationale, Dr. HRP reported that, “(t)he Veteran was not diagnosed with a mental disorder by this examiner. She does not meet diagnostic criteria for PTSD or any additional acquired mental disorder at this time. Therefore, there can be no causal link between the identified abuse and prior symptoms reported and an entity that was not found to be present. As noted in the body of the report, there is a recent history of a situationally bound mental health condition (an Adjustment Disorder). However, such was the result of more recent stressors including homelessness and unemployment. Additionally, this disorder has resolved during her current residency at the Hampton VAMC Domiciliary Program. At this time, she does not report significant psychiatric distress or impairment in daily functioning. As such, no disorder is diagnosed.” In March 2014, the Veteran submitted her notice of disagreement (NOD). Therein, the Veteran posited that, “I should be granted service connection for PTSD personal assault since my spouse, who was also on active duty, continued to assault me during my military service. I continued to seek counseling and psychiatric treatment during active duty due to the personal assault.” In September 2014, the Veteran’s service treatment records (STRs) were associated with her claims file. Therein, in August 1984, the following note was entered at the Naval Station Branch Clinic: “marital discord ~ 1 yr. Last month has been considering divorce. Husband physically abuses her on rare occasions, as today. Pt. states she was hit in the back of her head with an opened hand. This is the first time he has been very physical (). About 3 yrs ago he ‘choked’ her while in an argument.” In January 2017, the Veteran’s primary care physician submitted a statement. Therein, Dr. ALS commences by noting that, “(the Veteran) relates that the following problems as starting during her military service: neck and low back pain, shoulder pain, knee pain, depression and anxiety, and hearing loss ant tinnitus which has not been evaluated here.” Dr. ALS revealed that, “(the Veteran) has been hospitalized 3 times over the past several years—twice in 2007 and once in 2012—for severe depression and anxiety. She has followed up with outpatient mental health for ongoing treatment.” As the Board has revealed multiple times within its analysis, the first requisite element to substantiate an entitlement claims for service connection is a current disability. See 38 U.S.C. §§ 1110, 1131; 38 C.F.R. § 3.303 (a); see also Holton, 557 F.3d at 1366. In April 2013, the VA provider did not diagnosis any acquired psychiatric disability. Again, the VA provider did note that, “there is a recent history of a situationally bound mental health condition (an Adjustment Disorder). However, such was the result of more recent stressors including homelessness and unemployment . . .. At this time, she does not report significant psychiatric distress or impairment in daily functioning. As such, no disorder is diagnosed.” Ultimately, without a current diagnosis, the Veteran’s entitlement claim must be denied. Ultimately, the Board finds that the preponderance of the evidence stands counter to the Veteran’s entitlement claim. Since the preponderance of the evidence is against this acquired psychiatric disability claim, the provisions of 38 U.S.C. § 5107 (b), regarding reasonable doubt, are not applicable. The Veteran’s claim of entitlement to service connection for an acquired psychiatric disorder, to include   PTSD, must be denied, because the preponderance of the evidence weighs against her claim. DAVID L. WIGHT Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD RLBJ, Associate Counsel